Mental health outcomes, stigma and acceptance among women raising children born from sexual violence-related pregnancies

by Jennifer Scott, Shada Rouhani, Ashley Greiner, Katherine Albutt, Philipp Kuwert, Michele R Hacker, Michael VanRooyen, Susan BartelsBMJ Open 2015 Apr 8;5(4):e007057. DOI: 10.1136/bmjopen-2014-007057Abstract/ExcerptsThis 2012 study assessed mental health outcomes among women raising children from sexual violence-related pregnancies (SVRPs) in Bukavu, eastern Democratic Republic of Congo, and stigma toward and acceptance of women and their children.There were two study groups: (1) women raising children from SVRPs (parenting group) and (2) women who terminated SVRPs (termination group). Only parenting group data are presented in this manuscript. 757 adult women raising children from SVRPs who self-identified as a sexual violence survivor were interviewed.The findings demonstrate high rates of depression, PTSD, anxiety and suicidality among sexual violence survivors raising children from SVRPs.Participants were 33.8 ± 9.1 years of age and the children were 5.7 ± 2.3 years of age. At the time of the survey, women reported being married (31.9%), divorced or separated (28.7%), widowed (20.5%) or never married (12.2%); the remaining (6.8%) reported husband missing, living with partner, or other.The majority (88.5%) reported one sexual violence incident, while 11.5% reported more than one incident. The most common dates of sexual violence were 2004–2008. The majority of women reported ≥2 perpetrators (80.6%) and that the pregnancy was conceived in captivity (85.5%). Over 90% reported that the perpetrators were from a single armed group.Results 36.2% of participants reported no stigma. Stigma toward the woman from the community was reported by 38.4% of participants in varied ways: “I have been emotionally abused” (26%), “They make me feel dirty” (24.5%), “I have been raped” (23.7%), “I am not accepted by my peers” (20.6%), and “I am not allowed to participate in social events” (7.9%). Women who reported “the community stigmatizes me” were more likely to meet criteria for depression, post-traumatic stress disorder (PTSD), anxiety, and suicidality.48.6% of participants met symptom criteria for major depressive disorder, 57.9% for post-traumatic stress disorder, 43.3% for anxiety and 34.2% reported suicidality. Women who reported stigma from the community (38.4%) or who reported stigma toward the child from the spouse (42.9%), family (31.8%) or community (38.1%) were significantly more likely to meet symptom criteria for most mental health disorders. Although not statistically significant, participants who reported acceptance and acceptance of their children from the spouse, family and community were less likely to meet symptom criteria.Reports on children born of war have emphasised the importance of providing psychosocial support to women raising children from SVRPs, helping families honour the child’s existence and providing support to the mother, and providing options for women during and after SVRP (i.e. family planning and adoption services). For women who become pregnant from sexual violence, strengthening reproductive options and mental health support for women during the pregnancy and following the delivery of the child should be part of comprehensive programming.PHOTO + Google Earth Outreach Article